Objective To explore the clinical outcomes of the removal of nucleus pulposus with vertebral lamia fenestration in the treatment of lumbar disc herniation.Methods A total of 5482 patients with lumbar disc herniation were performed to remove nucleus pulposus with vertebral lamia fenestration.The follow-up study was conducted in 4329 cases for the duration varying from 6 months to 20 years,averaging 6.7 years,and the therapeutic effect of the operation was evaluated.Results After operation,the patients could walk in(3?2) days,resumed their daily activities in (15?6) days and went back to work in(28?9) days.According to the Nakai scale,excellent results were achieved in 3374 cases(77.9%),good in 652 cases(15.2%),improved in 249 cases(5.8%) and poor in 54 cases(1.1%).The rate of excellent and good results was 93.1%.Conclusion The advantages of the removal of nucleus pulposus with vertebral lamia fenestration are the removal of the annulus fibrosus,the calcified ligamentum flavum and osteophyte under direct vision.The operation may preserve the utmost integrity of the posterior lumbar structures,and the operative treatment has shown its good results.

Objective To investigate the changes of gene expression in the cardiac outflow tract (OFT) in Cx43 knockout (Cx43-/-) mouse embryos, and to elucidate the genes involved in the myocardialization of proximal cardiae outflow tract septum. Methods The cDNA was retrotranscripted from RNA, which extracted from OFT tissues of both Cx43-/- and Cx43 wild type (Cx43+/+) mouse embryos on embryonic day (ED) 14.5. The biotin-labeled cRNA derived from the transcription of cDNA was fragmented as probes. The probes were hybridized with Affymetrix Mouse Genome 430 2.0 Array. Gene Array Scanner was used to screen the signals of hybridization, and the expression of genes was detected. Results Among the differentially expressed genes, there were 143 upregulated and 235 downregulated in Cx43 knockout OFT tissue compared with those in Cx43+/+ heart. Functions of proteins encoded by the altered genes encompassed all functional categories, with the largest percentage in genes involved in signaling pathways such as regulation of transcription, cell cycle, etc. Among the differentially expressed genes in the Cx43-/- heart, some were related with TGFβ/BMP signaling pathway, and Ssr1, Ptk2 and Bmp6 were related with conotruncal defects. These genes were verified by Real-time PCR, and the result was consistent with that of microarray (P<0.05).Conclusions Scaned by Gene Array and verified by Real-time PCR, genes related with TGFβ/BMP signaling pathway, and Ssr1, Ptk2 and Bmp6 were differentially expressed in ED 14.5 Cx43-/- OFT tissue, which may be involved in the myocardialization of proximal cardiac outflow tract septum.

Objective To evaluate the effect of curcumin on spinal inflammatory factor in rats with diabetic neuropathy. Methods Diabetic neuropathy was induced by intraperitoneal injection with 1% STZ (60 mg/kg) in sprague-dawley rats. These diabetic rats were randomly allocated to diabetic group (D group, n=10) and curcumin group ( C group , n = 10 ) . Another 10 age-matched normal rats served as controlled group ( N group , n = 10 ) . 28 days after STZ injection, the rats in C group received daily intragastric administration of curcumin (200 mg/kg) whereas those in D group received the same volume of normal saline for 2 weeks. Caudal vein blood glucose levels at T1( before STZ injection)and at T2-T8(2、7、14、21、28、35、42 days after STZ injection)from all rats were detected. Responses to the mechanical stimulus were measured with von Frey filament, and paw withdraw threshold (PWT) was recorded at T1 and at T3 to T8. At T8,the rats were killed and lumbar segments of spinal cord were removed to detect TNF-αand IL-6 content. Results Compared to N group, rats in both C and D group showed hyperglycemia at T2 to T8 (P<0.05) and lower PWT at T4~ 8 (P < 0.01). Compared to D group, C group showed higher PWT at T7,8(P<0.05). Both D and C group showed higher levels of blood sugar at T2 ~ 8 than that at T1 (P < 0.05). C group showed higher PWT at T7,8 than that at T6(P<0.05). Compared to N group,spinal TNF-αand IL-6 content increased in both D and C groups (P<0.05). Compared to D group, C group had reduction of TNF-αand IL-6 concentration (P < 0.05). Conclusion Curcumin can attenuate diabetic neuropathic pain on rats probably by reducing inflammatory factor in spinal cord.

Objective To explore the possible risk factors that influence bone mineral density (BMD) in elderly men with type 2 diabetes. Methods A total of 80 elderly men with type 2 diabetes were included in this study. The BMD of lumbar vertebrae and femur were measured by dual-energy X-ray absorptiometry (DXA). And fasting blood and urine samples were taken to check the biochemical levels of bone metabolism and blood glucose. The correlations between BMD and other related factors were analyzed. Results In this group, the prevalence rates of osteoporosis and osteopenia were 18. 6% and 53.8%, respectively. Body mass and body mass index (BMI) were positively correlated with BMD at all sites (r=0. 202～0. 298, P<0. 05 or P<0. 01). However, age and glycosylated hemoglobin (HbAlc) were negatively correlated with BMD of lumbar and femoral neck (r=-0. 172～-0. 211 ,all P<0. 05). Leptin was not only positively correlated with the BMD of femoral neck and Ward's triangle, but also with body mass, BMI, fasting blood glucose (FBG), total cholesterol and HbAlc (r=0. 219 ～ 0. 509, P<0.05 or P<0.01). Using stepwise regression analysis, body mass was the predictor of BMD at all sites assessed, while the HbAlc and leptin levels could respectively influence BMD at femoral neck and Ward's triangle (r~2= 0. 196 ～ 0. 276, all P< 0. 01). Conclusions It may suggest that differential factors predict the variance of BMD at different sites in elderly men with type 2 diabetes.

Objective To conclude partial traumatic hemipelvectomy score and assess its value in partial traumatic hemipelvectomy treatment.Methods Data of the managements of 14 partial traumatic hemipelvectomy patients between January 2003 and December 2015 were retrospectively analyzed.10 of these patients were males and 4 females,with an average age of 31 (range,21-55).11 patients were brought directly to the hospital emergency department,and 3 patients were transferred from other hospitals.According to Tile classification system,all pelvic fractures were type C fracture:nine with type C 1,three with type C2 and two with type C3.Partial traumatic hemipelvectomy score was concluded according to soft tissue injury severity,the distance between hemi-pelvic and body axis,injury degree of iliac vessel and nerve.All these factors were further classified into four grades (range,1-4) on the basis of injury severity.Based on clinic outcomes and our experiences,hemipelvectomy should be performed at the early stage when patients had scores more than 12;if the score was between 8 and 12,reassessment should be done according to practical situation and hemipelvectomy was recommended;if the score was between 4 and 8,limb salvage was strongly recommended;if the score was below 4,limb salvage should be done.Results All 14 patients were assessed by partial traumatic hemipelvectomy.The average score was 11 (range,9-14).12 of them were scored at the range of 9-12.2 of them had scores more than 12.3 patients died during the initial resuscitation stage.7 patients underwent completion of the hindquarter amputation after control of hemorrhage and all the patients were successfully survived.Limb preservation was attempted in 4 patients:3 of them died eventually because of infection.1 patient underwent hip disarticulation in emergency operation,but this patient eventually required hindquarter amputation for severe infection.Conclusion Partial traumatic hemipelvectomy score could be a rapid and accurate tool in initial assessment of partial traumatic hemipelvectomy.After the control of hemorrhage,early hemipelvectomy could lower the death rate of this kind of patients.

Objective To investigate the expression of apolipoprotein M in rats after renal transplantation and its role and action mechanism in acute rejection (AR).Methods The kidney transplantation model in rats were established.Male SD and Wistar rats were used as donors,and Wistar rats as recipients.Three groups were designated:control group (syngeneic transplantation,n =24,recipients were treated with normal saline i.p.); AR group (allogeneic transplantation,n =24,recipients were treated with normal saline i.p.); PDTC group [allogeneic transplantation,n =24,recipients were treated with NF-κB inhibitor-pyrrolidine dithiocarbamat (PDTC) i.p.].The renal grafts were drawn at day 1,3,5 and 7 post-transplantation,and the expression levels of NF-κB P65 and apoM protein were detected by using Western blotting,and those of apoM,perforin and granzyme B mRNA were by using real-time PCR.The correlation of apoM and NF-κB,apoM and perforin,and apoM and granzyme B was respectively analyzed.Results As compared with control group,the expression levels of apoM,perforin and granzyme B mRNA in AR and PDTC groups were dramatically up-regulated at each time point (P＜0.01),and those in PDTC group were significantly lower than those in AR group (P＜0.01).The expression levels of apoM and NF-κB protein in AR group were both distinctly higher than those in control group (P＜0.01),and those in PDTC group were markedly lower than those in AR group (P＜0.01).A significantly positive correlation was found between the expression of apoM and NF-κB protein (r =0.469,P＜0.05).And the expression of apoM mRNA was positively correlated to perforin and granzyme B mRNA (r =0.731,P＜0.01 ; r =0.514,P＜0.05).Conclusion The expression of apoM is obviously up-regulated in renal grafts of rats,which may take part in the pathogenesis of AR via NF-κB.

Objective To compare the screening effects between Wells and revised Geneva scores on suspected acute pulmonary thromboembolism (APTE),and to explore a optimum screening method for APTE in the emergency department of China.Methods The study was carried out by using random,crossed,prospective methods to compare the screening effects between Wells and revised Geneva scores for 167 suspected APTE patients in the emergency department of the First Affiliated Hospital of Xiamen University.Results The areas under the receiver operating characteristic curve of Wells and revised Geneva scores for screening APTE in the emergency department were (0.917 ± 0.022 ) and (0.927 ± 0.020),respectively ( P ＜ 0.05 ).The diagnostic concordance between the two score systems for predicting APTE was poor (Kappa value =0.276 ). In addition, the difference between their hierarchical discrimination for the possibility of APTE was statistically significant ( P ＜ 0.05 ).Compared with revised Geneva score,fewer patients were diagnosed with low clinical probability of APTE and more patients were diagnosed with intermediate or high clinical probability of APTE through Wells score.The patients with low chnical probability of APTE were excluded from pulmonary embolism in Wells or revised Geneva score.At intermediate clinical probability,the accuracy rate of Wells score for predicting APTE (9.64％) was lower than that (32.84％ ) of revised Geneva ( P ＜ 0.05 ).At high clinical probability,there was no significant difference between their accuracy rate [ (67.24％ vs.86.21％),P＞0.05]. Conclusions Revised Geneva score is more suitable than Wells score in screening suspected APTE patients in the emergency department in our country.

Objective To investigate the surgical techniques and curative effect for the treatment of tibial plmeau fracture. Methods Totally 107 cases( male 62 cases;female 45 cases) of tibia plateau fractures were operated with internal fixation from January 2000 to December 2006 in our hospital. According to Schatzker classification,there were type Ⅰ fracture 2 cases,type Ⅱ 37 cases,type Ⅲ 29 cases,type Ⅳ 22 cases,type Ⅴ 10 cases,type Ⅵ 7 csses. Type Ⅰ fractures were treated with cannulated screws,other type fractures were treated by open reduction,internal fixation with buttress plates,and bone graft if bone defect existed. The therapeutic characteristics and the functions of the knee were evaluated. Results 107 cases cases were followed-up for 15 ～96 months,mean 28. 8 months.All fractures were healed without any complications. The knee Merchant scores were excellent in 62 cases, good in 24 cases,common in 17 cases,bad in 4 cases. The rate of fineness was 80. 37%. Conclusion Surgical operation is effective methods of treating tibia plateau fracture.

Objective To study the changes of pressure in cervical disc after percutaneous radiofrequency nucleoplasty,and provide theoretical basis for percutaneous radiofrequency nucleoplasty in the treatment of cervical disc herniation. Methods Forty-two patients with cervical disc herniation (33 cases of nerve root-type cervical spondylopathy and 9 cases of vertebral artery-type cervical spondylopathy) were treated with pereutaneous radiofrequeney nucleoplasty. The pressures of operated cervical disc were measured in the operation, and their clinical effects were evaluated using the JOA values 1 week after operation. The relationship between pressure changes in cervical disc and clinical effect was studied. Results The pressure in the cervical disc in 33 cases of nerve root-type cervical spondylopathy was decreased (1.84 ± 0.96) kPa (P=0.000), and the JOA values increased (3.27 ± 1.35) scares (P=0.000) 1 week after operation. The pressure in the cervical disc in 9 cases of vertebral artery-type cervical spondylopathy was decreased (1.72 ± 0.92) kPa (P= 0.000), and the JOA values increased (2.78 ± 0.67) scores (P= 0.000) 1 week after operation. Correlative analysis showed that there was a positive correlation between the pressure decrease of cervical disc and the JOA values increase (P < 0.05). Conclusion Percutaneous radiofrequency nucleoplasty can help to reduce pressure in the cervical disc and relieve the clinical symptoms.

Objective To observe the effects of low intensity electromagnetic fields (LIEMFs) in promoting the reconstruction of full skin loss wounds grafted with human epidermal stem cells (ESCs). Methods Fifty nude mice aged 7 to 8 weeks with full skin loss wounds were equally divided into 3 experimental subgroups ( 1 Hz, 10Hz and 50Hz) and two control groups (a cell suspension control group and a blank control group) , with ten mice each. In the 3 experimental subgroups and the cell suspension control group, ESCs separated from human foreskin and cultured in vitro were grafted to the wounds using collagen sponge scaffolds. The experimental subgroups were then stimulated with an LIEMF (magnetic field intensity 5mT) at the appropriate frequency for 30min/day for 15 days. The blank control group was put under the same conditions without the cell suspension and LIEMF. The healing rates of the wounds were observed, and tissue slices were stained and observed under a light microscope. The inner structure of the regenerating skin was observed using transmission electron microscopy. Results The ESCs were successfully grafted. A few human integrin β1 positive stained cells appeared in the regenerating skin. The average healing rates in the experimental subgroups were significantly superior to those of the control groups. Well differentiated epidermis and dermis could be seen in the regenerating skin in all of the experimental groups. The epidermis had more cell layers and was thicker than in the control groups. More desmosome, hemidesmosome and keratin filaments were seen among the epidemic cells of the experimental groups. Conclusions LIEMF promotes the healing of full skin loss wounds grafted with ESCs in nude mice, and can promote complete repair of skin defects and the regeneration of skin function.